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{{congestive heart failure}}
{| class="infobox" style="float:right;"
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| [[File:Siren.gif|30px|link= Heart failure resident survival guide]]|| <br> || <br>
| [[Heart failure resident survival guide|'''Resident'''<br>'''Survival'''<br>'''Guide''']]
|}
{{Congestive heart failure}}
{{CMG}}
{{CMG}}


==Overview==
==Overview==
There are several classification schemes used to characterize the pathophysiology of heart failure as either [[systolic dysfunction|systolic]] vs [[diastolic dysfunction|diastolic]]; left vs right; or low output vs [[High output failure|high output]].  The anatomic structure underlying the disease process is often characterized as well.  The causes of heart failure are also often characterized by their chronicity (acute/decompensated or chronic).


There are several classification schemes used to characterize the pathophysiology of heart failure as either systolic vs diastolic; left vs right; or low output vs high output.  The anatomic structure underlying the disease process is often characterized as well.  The causes of heart failure are also often characterized by their chronicity (acute/decompensated or chronic).
==Causes==
===Life Threatening Causes===
Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated.  Congestive heart failure is life threatening and should be treated as such irrespective of the underlying cause.


==Underlying Anatomic Abnormalities Causing Heart Failure==
===Common Causes===
Heart failure may result from an abnormality of any one of the anatomical structures of the heart:
*[[Arrhythmias]]
*[[Pericardium]]
*[[Cardiomyopathy|Cardiomyopathies]]
*[[Myocardium]]
*[[Cardiotoxicity|Cardiotoxins (e.g., alcohol, cocaine, aprotinin)]]
*[[Endocardium]]
*[[Congenital heart disease]]
*[[Valvular heart disease]] or
*[[Hypertension]]
*Disorders of the great vessels (e.g. [[pulmonary hypertension]])
*[[Ischemic heart disease]]
*[[Pericarditis]]
*[[Pulmonary embolism]]
*[[Valvular heart disease]]
*[[Viral myocarditis]]


==Systolic versus Diastolic Heart Failure==
===Causes by Organ System===
Patients may be broadly classified as having heart failure with depressed contractility or depressed relaxation
{|style="width:75%; height:100px" border="1"
===Systolic Dysfunction===
|style="height:100px"; style="width:25%" border="1" bgcolor="LightSteelBlue" |'''Cardiovascular'''
The [[left ventricular ejection fraction]] is reduced in [[systolic dysfunction]] and there is depressed contractility of the heart.
|style="height:100px"; style="width:75%" border="1" bgcolor="Beige" |[[Aortic regurgitation]], [[aortic stenosis]], [[arrhythmias]], [[arrhythmogenic right ventricular dysplasia]], [[arteriovenous fistula]], [[atrial fibrillation]], [[atrial septal defect]], [[cardiac amyloidosis]], [[aneurysm|cardiac aneurysm]], [[congenital heart disease]], [[constrictive pericarditis]], [[dilated cardiomyopathy]], [[Eisenmenger syndrome]], [[endocarditis]], [[hypertension]], [[hypertrophic cardiomyopathy]], [[hypoplastic left heart syndrome]], [[interferon gamma]], [[ischemic heart disease]], [[malignant hypertension]], [[mitral regurgitation]], [[mitral stenosis]], [[myocardial infarction]], [[oxaprozin]], [[patent ductus arteriosus]], [[pericardial effusion]], [[pericardial tamponade]], [[pericarditis]], [[peripartum cardiomyopathy]], [[pertuzumab]], [[restrictive cardiomyopathy]], [[rheumatic fever|rheumatic carditis]], [[rupture of the papillary muscles]], [[Takotsubo cardiomyopathy]], [[tricuspid insufficiency]], [[valvular heart disease]], [[ventricular aneurysm]], [[ventricular septal defect]]
===Disastolic Dysfunciton===
|-
The [[left ventricular ejection fraction]] is preserved in [[diastolic dysfunction]] and there is an abnormality in myocardial relaxation or excessive myocardial stiffness. Systolic and diastolic dysfunction commonly occur in conjunction with each other.
|bgcolor="LightSteelBlue"| '''Chemical/Poisoning'''
|bgcolor="Beige"| [[Ethylene glycol]]
|-
|-bgcolor="LightSteelBlue"
| '''Dental'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Dermatologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Drug Side Effect'''
|bgcolor="Beige"|  [[Ado-trastuzumab emtansine]], [[bicalutamide]],[[bicisate dihydrochloride]], [[carfilzomib]], [[certolizumab pegol]], [[cidofovir]], [[cinacalcet]], [[cyclophosphamide]], [[dexamethasone]], [[diclofenac (patch)]], [[disulfiram]],[[dornase alfa]], [[doxorubicin hydrochloride]], [[epirubicin ]],  [[epoetin alfa]], [[felbamate]], [[ferumoxytol]], [[flurbiprofen]], [[goserelin]], [[hydroxyethyl starch]], [[ibuprofen lysine]], [[idarubicin hydrochloride]], [[idursulfase]], [[imatinib]], [[ixabepilone]], [[levothyroxine]], [[mefenamic acid]], [[meloxicam]], [[meropenem]], [[methoxy polyethylene glycol-epoetin beta]], [[methylprednisolone]], [[metoclopramide]], [[mitomycin]], [[mitoxantrone]], [[muromonab-CD3]], [[nilutamide]], [[nitroglycerin]],[[oprelvekin]], [[oxcarbazepine]], [[Peginterferon Beta-1a]],[[pergolide]], [[phenylbutazone]], [[piroxicam]],  [[ponatinib hydrochloride]], [[pramipexole]], [[prednisone]], [[prednisolone]], [[rubidium Rb 82]], [[sorafenib]], [[sulindac]], [[sunitinib malate]], [[tolmetin]], [[trastuzumab]], [[valdecoxib]], [[vandetanib]]


==Left, Right and Biventricular Failure==
|-
Another common method of classifying heart failure is based upon the ventricle involved (left sided versus right sided).
|-bgcolor="LightSteelBlue"
===Left Heart Failure===
| '''Ear Nose Throat'''
*There is impaired left ventricular function with reduced flow into the aorta.
|bgcolor="Beige"| No underlying causes
===Right Heart Failure===
|-
*There is impaired right ventricular function with reduced flow into the pulmonary artery and lungs.
|-bgcolor="LightSteelBlue"
===Biventricular Failure===
| '''Endocrine'''
*The most common cause of right heart failure is left heart failure, and mixed presentations are common, especially when the cardiac septum is involved.
|bgcolor="Beige"| [[Diabetes mellitus]], [[hyperthyroidism]], [[hypothyroidism]], [[thyrotoxicosis]]
|-
|-bgcolor="LightSteelBlue"
| '''Environmental'''
|bgcolor="Beige"| [[Coalworker's pneumoconiosis]], [[silicosis]]
|-
|-bgcolor="LightSteelBlue"
| '''Gastroenterologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Genetic'''
|bgcolor="Beige"| [[Atrial septal defect]], [[congenital heart disease]], [[Friedreich's ataxia]], [[glycogen storage disease]], [[Marfan's syndrome]], [[Mulibrey nanism|Mulibrey nanism syndrome]], [[muscular dystrophy]], [[Noonan syndrome]], [[ventricular septal defect]]
|-
|-bgcolor="LightSteelBlue"
| '''Hematologic'''
|bgcolor="Beige"| [[Anemia|Severe anemia]]
|-
|-bgcolor="LightSteelBlue"
| '''Iatrogenic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Infectious Disease'''
|bgcolor="Beige"|[[Endocarditis]], [[human immunodeficiency virus]], [[Lyme disease]], [[pericarditis]], [[rheumatic fever|rheumatic carditis]], [[rheumatic fever]], [[sepsis]], [[viral myocarditis]], [[Whipple's disease]]
|-
|-bgcolor="LightSteelBlue"
| '''Musculoskeletal/Orthopedic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Neurologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Nutritional/Metabolic'''
|bgcolor="Beige"| [[Ascorbic acid deficiency]], [[beriberi]], [[carnitine deficiency]], [[glycogen storage disease]], [[hemochromatosis]], [[metabolic acidosis]], [[Paget's disease]]
|-
|-bgcolor="LightSteelBlue"
| '''Obstetric/Gynecologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Oncologic'''
|bgcolor="Beige"| [[Pancoast tumor]]
|-
|-bgcolor="LightSteelBlue"
| '''Ophthalmologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Overdose/Toxicity'''
|bgcolor="Beige"| [[Alcohol]], [[atenolol]], [[dronedarone]], [[imatinib mesylate]], [[propranolol]], [[verapamil]]
|-
|-bgcolor="LightSteelBlue"
| '''Psychiatric'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Pulmonary'''
|bgcolor="Beige"| [[Coalworker's pneumoconiosis]], [[cor pulmonale]], [[hypoxia]], [[Pickwickian syndrome]], [[pulmonary artery stenosis]], [[pulmonary embolism]], [[pulmonary fibrosis]], [[pulmonary hypertension]], [[pulmonary valve stenosis]], [[pulmonary vein stenosis]], [[pulmonic regurgitation]], [[silicosis]]
|-
|-bgcolor="LightSteelBlue"
| '''Renal/Electrolyte'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Rheum/Immune/Allergy'''
|bgcolor="Beige"| [[Cardiac amyloidosis]], [[sarcoidosis]], [[systemic lupus erythematosus]]
|-
|-bgcolor="LightSteelBlue"
| '''Sexual'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Trauma'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Urologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Miscellaneous'''
|bgcolor="Beige"| No underlying causes
|-
|}


==High Output Versus Low Output Failure==
===Causes in Alphabetical Order===
===Low Output Failure===
{{columns-list|
*The [[cardiac output]] is reduced, and the [[systemic vascular resistance]] ([[SVR]]) is high.  In low output failure, there is an inadequate supply of blood flow to meet normal metabolic demands.
*[[Ado-trastuzumab emtansine]]
 
*[[Alcoholism]]
===High Output Failure===
*[[Anemia]]
*The [[cardiac output]] is increased, and the [[systemic vascular resistance]] ([[SVR]]) is low.  Rather than an inadequate supply of blood flow to meet normal metabolic demands as occurs in low output failure, in high output failure there is an excess requirement for oxygen and nutrients and the demand outstrips what the heart can provide.<ref>{{DorlandsDict|nine/000953450|high-output heart failure}}</ref> Causes of high output heart failure include severe [[anemia]], Gram negative [[septicaemia]], [[beriberi]] (vitamin B<sub>1</sub>/thiamine deficiency), [[thyrotoxicosis]], [[Paget's disease of bone|Paget's disease]], [[arteriovenous fistula]]e, or [[arteriovenous malformation]]s.
*[[Aortic insufficiency]]
 
*[[Aortic stenosis]]
==Causes of Acute or Decompensated Heart Failure==
*[[Arrhythmias]]
Chronic stable heart failure may easily decompensate. This most commonly results from an intercurrent illness (such as [[pneumonia]]), [[myocardial infarction]] (a heart attack), [[cardiac arrhythmia|arrhythmias]], uncontrolled [[hypertension]], or a patient's failure to maintain a fluid restriction, diet, or medication.<ref name="OPTIMIZE-HF">{{cite journal |author=Fonarow GC, Abraham WT, Albert NM, ''et al.'' |title=Factors Identified as Precipitating Hospital Admissions for Heart Failure and Clinical Outcomes: Findings From OPTIMIZE-HF |journal=Arch. Intern. Med. |volume=168 |issue=8 |pages=847–854 |year=2008 |month=April |pmid=18443260 |doi=10.1001/archinte.168.8.847}}</ref> Other well recognized precipitating factors include [[anemia]] and [[hyperthyroidism]] which place additional strain on the heart muscle. Excessive fluid or salt intake, and medication that causes fluid retention such as [[Non-steroidal anti-inflammatory drug|NSAIDs]] and [[thiazolidinedione]]s, may also precipitate decompensation.<ref>{{cite journal |author=Nieminen MS, Böhm M, Cowie MR, ''et al.'' |title=Executive summary of the guidelines on the diagnosis and treatment of acute heart failure: the Task Force on Acute Heart Failure of the European Society of Cardiology |journal=Eur. Heart J. |volume=26 |issue=4 |pages=384–416 |year=2005 |month=February |pmid=15681577 |doi=10.1093/eurheartj/ehi044 |url=http://eurheartj.oxfordjournals.org/cgi/content/full/26/4/384}}</ref>
 
==Differential Diagnosis of the Underlying Causes of Chronic Heart Failure==
===Common Causes of Left Sided Heart Failure===
* [[Aortic Regurgitation|Aortic regurgitation]]
* [[Aortic Stenosis|Aortic stenosis]]
* [[Hypertension]]
* [[Mitral Regurgitation|Mitral regurgitation]]
* [[Myocardial ischemia]]
 
A 19 year study of 13,000 healthy adults in the United States (the [[National Health and Nutrition Examination Survey]] (NHANES I) found the following causes ranked by Population Attributable Risk score:<ref>{{cite journal |author=He J; Ogden LG; Bazzano LA; Vupputuri S, ''et al.'' |title=Risk factors for congestive heart failure in US men and women: NHANES I epidemiologic follow-up study|journal=Arch. Intern. Med. |volume=161 |issue=7 |pages=996–1002|year=2001 |pmid= 11295963 |doi=10.1001/archinte.161.7.996 }}</ref>
#[[Ischaemic heart disease]] 62%
#[[Tobacco smoking|Cigarette smoking]] 16%
#[[Hypertension]] (high blood pressure)10%
#[[Obesity]] 8%
#[[Diabetes]] 3%
#[[Valvular heart disease]] 2%  (much higher in older populations)
 
===Cardiomyopathies and Inflammatory Diseases===
 
=====[[Restrictive Cardiomyopathies]]=====
* [[Amyloidosis]]  
* [[Anthracyclines]]
* [[Cardiac transplant]]
* [[Endocardial fibrosis]]
* [[Eosinophilic heart disease]]
* [[Hemochromatosis]]
* Primary (idiopathic)
* [[Radiation therapy]]
* [[Sarcoidosis]]
* Storage diseases
* [[Tumor]] infiltration
 
=====[[Dilated Cardiomyopathies]]=====
*[[Duchenne muscular dystrophy]]
*[[Becker's muscular dystrophy]]
*[[Limb-girdle muscular dystrophy]]
*[[Mitochondrial myopathy]]
*:*[[Kearns-Sayre syndrome]]
*[[Arrhythmogenic right ventricular dysplasia]]
*[[Arrhythmogenic right ventricular dysplasia]]
*[[Alcohol-Induced cardiomyopathy]]
*[[Arteriovenous fistula]]
*[[Cocaine related cardiomyopathy]]
*[[Ascorbic acid deficiency]]
*[[Diabetic cardiomyopathy]]
*[[Atenolol]]
*[[Atrial fibrillation]]
*[[Atrial septal defect]]
*[[Beriberi]]
*[[Bicalutamide]]
*[[Bicisate dihydrochloride]]
*[[Cardiac amyloidosis]]
*[[Aneurysm|Cardiac aneurysm]]
*[[Carfilzomib]]
*[[Carnitine deficiency]]
*[[Certolizumab pegol]]
*[[Cidofovir]]
*[[Cinacalcet]]
*[[Coalworker's pneumoconiosis]]
*[[Congenital heart disease]]
*[[Constrictive pericarditis]]
*[[Cor pulmonale]]
*[[Cyclophosphamide]]
*[[Dexamethasone]]
*[[Diabetes mellitus]]
*[[Diclofenac (patch)]]
*[[Dilated cardiomyopathy]]
*[[Disulfiram]]
*[[Dornase alfa]]
*[[Doxorubicin Hydrochloride]]
*[[Dronedarone]]
*[[Eisenmenger syndrome]]
*[[Endocarditis]]
*[[Epirubicin]]
*[[Epoetin alfa]]
*[[Ethylene glycol]]
*[[Felbamate]]
*[[Ferumoxytol]]
*[[Flurbiprofen]]
*[[Friedreich's ataxia]]
*[[Glycogen storage disease]]
*[[Goserelin]]
*[[Hemochromatosis]]
*[[Human immunodeficiency virus]]
*[[Hydroxyethyl starch]]
*[[Hypertension]]
*[[Hyperthyroidism]]
*[[Hypertrophic cardiomyopathy]]
*[[Hypoplastic left heart syndrome]]
*[[Hypothyroidism]]
*[[Hypoxia]]
*[[Idarubicin hydrochloride]]
*[[Ibuprofen lysine]]
*[[Idursulfase]]
*[[Imatinib mesylate]]
*[[Interferon gamma]]
*[[Ischemic heart disease]]
*[[Ixabepilone]]
*[[Levothyroxine]]
*[[Lyme disease]]
*[[Malignant hypertension]]
*[[Marfan's syndrome]]
*[[Mefenamic acid]]
*[[Meloxicam]]
*[[Meropenem]]
*[[Metabolic acidosis]]
*[[Methoxy polyethylene glycol-epoetin beta]]
*[[Methylprednisolone]]
*[[Metoclopramide]]
*[[Mitomycin]]
*[[Mitoxantrone]]
*[[Mitral regurgitation]]
*[[Mitral stenosis]]
*[[Mulibrey nanism|Mulibrey nanism syndrome]]
*[[Muromonab-CD3]]
*[[Muscular dystrophy]]
*[[Myocardial infarction]]
*[[Nilutamide]]
*[[Nitroglycerin]]
*[[Noonan syndrome]]
*[[Oprelvekin]]
*[[Oxaprozin]]
*[[Paget's disease]]
*[[Pancoast's tumor]]
*[[Patent ductus arteriosus]]
*[[Peginterferon Beta-1a]]
*[[Pergolide]]
*[[Pericardial effusion]]
*[[Pericardial tamponade]]
*[[Pericarditis]]
*[[Peripartum cardiomyopathy]]
*[[Peripartum cardiomyopathy]]
*[[Anthracycline induced cardiomyopathy]]
*[[Phenylbutazone]]
*[[Trastuzumab]] [[Herceptin-lnduced Cardiomyopathy]]
*[[Pickwickian syndrome]]
 
*[[Piroxicam]]
=====Inflammatory Cardiomyopathies=====
*[[Ponatinib hydrochloride]]
 
*[[Pneumococcal Vaccine 13-Valent]] ([[Prevnar 13]])
*[[Bacterial Myocarditis]]
*[[Pramipexole]]
*[[Fungal myocarditis]]
*[[Propranolol]]
*[[Giant Cell Myocarditis]]
*[[Prednisone]]
*[[Myocarditis|Protozoal Myocarditis]]: [[Trypanosomiasis]] ([[Chagas Disease]])
*[[Prednisolone]]
*[[Rickettsial Myocarditis]]
*[[Pulmonary artery stenosis]]
*[[Pulmonary embolism]]
*[[Pulmonary fibrosis]]
*[[Pulmonary hypertension]]
*[[Pulmonary valve stenosis]]
*[[Pulmonary vein stenosis]]
*[[Pulmonic regurgitation]]
*[[Restrictive cardiomyopathy]]
*[[Rheumatic fever|Rheumatic carditis]]
*[[Rheumatic fever]]
*[[Rubidium Rb 82]]
*[[Rupture of the papillary muscles]]
*[[Sarcoidosis]]
*[[Sarcoidosis]]
*[[Spirochetal Infections]]
*[[Sepsis]]
*[[Viral Myocarditis]]
*[[Silicosis]]
 
*[[Sorafenib]]
===Congestive Heart Failure as a Consequence of Valvular Heart Disease===
*[[Sulindac]]
*[[Aortic stenosis with Left Ventricular Systolic Dysfunction]]
*[[Sunitinib malate]]
*[[Chronic aortic regurgitation]]
*[[Systemic lupus erythematosus]]
*[[Mitral Stenosis]]
*[[Takotsubo cardiomyopathy]]
*[[Chronic mitral regurgitation]]
*[[Thyrotoxicosis]]
*[[Acute aortic regurgitation]]
*[[Tolmetin]]
*[[Acute mitral regurgitation]]
*[[Trastuzumab]]
 
*[[Tricuspid insufficiency]]
===Congestive Hert Failure Secondary to Congenital Heart Disease===
*[[Valdecoxib]]
 
*[[Vandetanib]]
'''A. Causes of Congestive Heart Failure in Adults with Unoperated Congenital Heart Diseases'''
*[[Valvular heart disease]]
*[[Eisenmenger's syndrome]]
*[[Ventricular aneurysm]]
*Fibrocalcific degeneration of abnormal [[aortic valve]]  
*[[Ventricular septal defect]]
*Systemic ventricular dysfunction and/or [[tricuspid regurgitation]] in congenitally corrected transposition of the great arteries
*[[Verapamil]]
*[[Atrial septal defect]] with [[mitral regurgitation]]] secondary to myxomatous mitral valve
*[[Viral myocarditis]]
*[[Congenital mitral regurgitation]]
*[[Whipple's disease]]
*[[Arrhythmia]]
}}
*[[Endocarditis]]  
*Other degenerative diseases ([[coronary artery disease]], [[hypertension]])
*[[Drug abuse]], [[alcohol abuse]]  
*[[Pregnancy]]
 
'''B. Causes of Congestive Heart Failure in Adults with Operated Congenital Heart Diseases'''
*Myocardial dysfunction
*Valvular regurgitation
*Persistent left-to-right shunt
*Pulmonary vascular disease  
*Prosthetic valve dysfunction
*Status post [[Fontan operation]]
*[[Arrhythmia]]
*[[Endocarditis]]  
*Other degenerative diseases ([[coronary artery disease]], [[hypertension]])
 
=== Right Ventricular Failure ===
Factors affected right ventricle and to be eliminated during management of congestive heart failure.
A. Right ventricular myocardial dysfunction
#[[Right ventricular myocardial infarction]]  
#[[Dilated cardiomyopathy]]
#[[Arrhythmogenic right ventricular dysplasia|Right ventricular dysplasia]]
B. Primary right ventricular pressure overload
#[[Left ventricular failure]]
#[[Mitral valve]] disease
#[[Atrial myxoma]]
#[[Pulmonary veno-occlusive disease]]
#[[Cor pulmonale]]
#:*[[Chronic obstructive pulmonary disease]]
#:*[[Primary pulmonary hypertension]]
#:*[[Pulmonary embolism]]
#[[Pulmonic stenosis]]
#:*[[Supravalvular pulmonic stenosis]]
#:*[[Valvular pulmonic stenosis]]
#:*[[Subvalvular pulmonic stenosis]]
#[[Ventricular septal defect]]  
#Aortopulmonary communication
C. Primary right ventricular volume overload
#[[Pulmonic regurgitation]]
#[[Tricuspid regurgitation]]
#[[Atrial septal defect]]
#[[Partial anomalous pulmonary venous return]]
D. Impediment to right ventricular inflow
#[[Tricuspid stenosis]]
#[[Cardiac tamponade]]
#[[pericarditis |Constrictive pericarditis]]
#[[cardiomyopathy|Restrictive cardiomyopathy]]
 
== Differential Diagnosis of Causes of Heart Failure Segregated by Left and Right Sided Heart Failure==
===Left Ventricular Failure===
====Most Common Causes:====
* [[Aortic Regurgitation|Aortic regurgitation]]
* [[Aortic Stenosis|Aortic stenosis]]
* [[Hypertension]]
* [[Mitral Regurgitation|Mitral regurgitation]]
* [[Myocardial ischemia]]
 
====Expanded List of Causes:====
* [[Atrial fibrillation]]
* [[Alcoholism]]
* [[Anemia]]
* [[Angina]]
* [[Aortic Regurgitation|Aortic regurgitation]]
* [[Aortic Stenosis]]
* [[Arteriovenous fistula]]
* [[Beriberi]]
* [[aneurysm|Cardiac aneurysm]]
* [[Cardiomyopathy]]
* [[pericarditis|Constrictive pericarditis]]
* [[Drugs]], [[toxin]]s
* [[Hypertension]]
* [[Hyperthyroidism]]
* [[Hypovolemia]]
* [[Hypoxia]]
* Mediastinal tumors
* [[Mitral Regurgitation]]
* [[Myocardial Infarction]]
* [[Paget's Disease]]
* [[Pancoast's Tumor]]
* [[Pericardial effusion]]
* [[Pericardial tamponade]]
* [[Perimyocarditis]]
* [[Protein deficiency]]
* [[Restrictive cardiomyopathy]]
* [[Papillary muscle rupture|Rupture of the papillary muscles]]
* [[Sepsis]]
* [[Superior Vena Cava]] thrombosis
 
===Right Ventricular Failure ===
====Most Common Causes:====
* [[Cardiomyopathy]]
* [[Cor pulmonale]]
* [[myocarditis|Diffuse myocarditis]]
* Left heart failure
 
====Other Causes:====
* After [[left ventricular failure]]
* After pulmonary resection
* [[Alveolitis|Allergic alveolitis]]
* [[asthma|Bronchial asthma]]
* [[bronchitis|Chronic bronchitis]]
* [[Alveolitis|Honeycomb lung]]
* [[Hyperglobulia]]
* [[Emphysema]]
* [[Mitral Stenosis]]
* [[Right ventricular myocardial infarction]]
* [[Pickwickian Syndrome]]
* Pleural fibrosis
* [[Pneumoconiosis]]
* [[Pulmonary fibrosis]]
* [[Pulmonic regurgitation]]
* [[Pulmonic stenosis]]
* [[Sarcoidosis]]
* [[pulmonary emboli|Severe relapsing pulmonary emboli]]
* [[Silicosis]]
* [[Tachycardia]]
* [[Tricuspid insufficiency]]
 
===Others===
* [[Ascorbic acid deficiency]]
* [[Cardiac amyloidosis]]
* [[Carnitine deficiency]]
* Cervical vein stasis of non-cardiac genesis
* [[Congenital heart disease]]
* [[Cyanosis]] of non-cardiac genesis
* [[Diabetes Mellitus]]
* [[Ddx:Dyspnea|Dyspnea]] of non-cardiac genesis
* [[Edema]] of non-cardiac genesis
* [[Hemochromatosis]]
* [[Pleural effusion]] of non-cardiac genesis
* [[Pulmonary edema]] of non-cardiac genesis
* [[Thiamine deficiency]]
* [[Thyroid disease]]


==References==
==References==
{{Reflist|2}}
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Latest revision as of 21:05, 29 July 2020
Resident
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Coordinating Care for Patients With Chronic HF
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

There are several classification schemes used to characterize the pathophysiology of heart failure as either systolic vs diastolic; left vs right; or low output vs high output. The anatomic structure underlying the disease process is often characterized as well. The causes of heart failure are also often characterized by their chronicity (acute/decompensated or chronic).

Causes

Life Threatening Causes

Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated. Congestive heart failure is life threatening and should be treated as such irrespective of the underlying cause.

Common Causes

Causes by Organ System

Cardiovascular Aortic regurgitation, aortic stenosis, arrhythmias, arrhythmogenic right ventricular dysplasia, arteriovenous fistula, atrial fibrillation, atrial septal defect, cardiac amyloidosis, cardiac aneurysm, congenital heart disease, constrictive pericarditis, dilated cardiomyopathy, Eisenmenger syndrome, endocarditis, hypertension, hypertrophic cardiomyopathy, hypoplastic left heart syndrome, interferon gamma, ischemic heart disease, malignant hypertension, mitral regurgitation, mitral stenosis, myocardial infarction, oxaprozin, patent ductus arteriosus, pericardial effusion, pericardial tamponade, pericarditis, peripartum cardiomyopathy, pertuzumab, restrictive cardiomyopathy, rheumatic carditis, rupture of the papillary muscles, Takotsubo cardiomyopathy, tricuspid insufficiency, valvular heart disease, ventricular aneurysm, ventricular septal defect
Chemical/Poisoning Ethylene glycol
Dental No underlying causes
Dermatologic No underlying causes
Drug Side Effect Ado-trastuzumab emtansine, bicalutamide,bicisate dihydrochloride, carfilzomib, certolizumab pegol, cidofovir, cinacalcet, cyclophosphamide, dexamethasone, diclofenac (patch), disulfiram,dornase alfa, doxorubicin hydrochloride, epirubicin , epoetin alfa, felbamate, ferumoxytol, flurbiprofen, goserelin, hydroxyethyl starch, ibuprofen lysine, idarubicin hydrochloride, idursulfase, imatinib, ixabepilone, levothyroxine, mefenamic acid, meloxicam, meropenem, methoxy polyethylene glycol-epoetin beta, methylprednisolone, metoclopramide, mitomycin, mitoxantrone, muromonab-CD3, nilutamide, nitroglycerin,oprelvekin, oxcarbazepine, Peginterferon Beta-1a,pergolide, phenylbutazone, piroxicam, ponatinib hydrochloride, pramipexole, prednisone, prednisolone, rubidium Rb 82, sorafenib, sulindac, sunitinib malate, tolmetin, trastuzumab, valdecoxib, vandetanib
Ear Nose Throat No underlying causes
Endocrine Diabetes mellitus, hyperthyroidism, hypothyroidism, thyrotoxicosis
Environmental Coalworker's pneumoconiosis, silicosis
Gastroenterologic No underlying causes
Genetic Atrial septal defect, congenital heart disease, Friedreich's ataxia, glycogen storage disease, Marfan's syndrome, Mulibrey nanism syndrome, muscular dystrophy, Noonan syndrome, ventricular septal defect
Hematologic Severe anemia
Iatrogenic No underlying causes
Infectious Disease Endocarditis, human immunodeficiency virus, Lyme disease, pericarditis, rheumatic carditis, rheumatic fever, sepsis, viral myocarditis, Whipple's disease
Musculoskeletal/Orthopedic No underlying causes
Neurologic No underlying causes
Nutritional/Metabolic Ascorbic acid deficiency, beriberi, carnitine deficiency, glycogen storage disease, hemochromatosis, metabolic acidosis, Paget's disease
Obstetric/Gynecologic No underlying causes
Oncologic Pancoast tumor
Ophthalmologic No underlying causes
Overdose/Toxicity Alcohol, atenolol, dronedarone, imatinib mesylate, propranolol, verapamil
Psychiatric No underlying causes
Pulmonary Coalworker's pneumoconiosis, cor pulmonale, hypoxia, Pickwickian syndrome, pulmonary artery stenosis, pulmonary embolism, pulmonary fibrosis, pulmonary hypertension, pulmonary valve stenosis, pulmonary vein stenosis, pulmonic regurgitation, silicosis
Renal/Electrolyte No underlying causes
Rheum/Immune/Allergy Cardiac amyloidosis, sarcoidosis, systemic lupus erythematosus
Sexual No underlying causes
Trauma No underlying causes
Urologic No underlying causes
Miscellaneous No underlying causes

Causes in Alphabetical Order

References

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